Providers
We go the extra mile to fulfill your chosen therapy as quickly as possible and help you succeed in treatment.
Managing your patients’ complex conditions and therapies can be difficult – especially where specialty prescriptions are involved.
Specialty medications are our specialty.
We make it easy – Our Team of Patient Care Advocates and Pharmacists are experienced and knowledgeable in both specialty and non-specialty prescriptions, navigating the insurance authorization process, and connecting patients to available financial resources such as patient assistance and grant or foundation support.
Specialty prescriptions are different. Often, the prescription will need Prior Authorization. PA’s are a fact of life, but Evergreen Pharmacy is here to help.
We collect information about the patient’s prescription benefit that you will need to be sure the specialty medication meets various requirements of the insurance company. We assist in the start of the PA process through various resources – electronic, telephone, or paper. The process can take a few days, a week, and sometimes longer for approval. If we have access to electronic medical records, the process can be shortened significantly. The goal is to have the patient start therapy as soon as possible.
If the prescription is approved, we’ll be in touch with you and the patient. We will consult the patient regarding the specialty medication, including training on self-injection when appropriate. We will schedule delivery and discuss a schedule going forward.
If the prescription is not approved, we will let the patient know. We will also let you know, so that the next steps can be determined. If an appeal is appropriate, we can help to draft this and help in the process of appeal. Sometimes approval is given, but we are not allowed to fill due to restrictions in the patient’s insurance coverage or due to the manufacturer of the medication limiting the number of pharmacies that are allowed access to the drug. We will contact the patient and let them know, and contact you so you have all the information.
Our Services
We contact insurance companies to determine PA requirements and can begin the process. We participate in CoverMyMeds and other services to expedite the process. If an appeal is needed, we can assist with this as well.
While written information is provided about the specialty medication and the way to use it, our pharmacists can make it much easier to understand. Usually, while we are checking with the insurance company, one of our staff will call the patient and explain how the process works. At that time, the patient may also speak with a pharmacist. They counsel patients about how the specialty medication works, how to administer the medication, what to watch for in terms of potential reactions, what to do if there is a reaction, and answer any other questions. Every patient will be counseled by one of our pharmacists.
We make arrangements for medications to be delivered. Our delivery service handles most of our deliveries in southeastern Wisconsin and northern Illinois. Some areas are shipped via UPS or USPS when appropriate.
Our pharmacists are trained and expert at helping patients with their injections. If the patient is uncomfortable with self-injection, our pharmacist can help by administering the medication. For some medications, it is not recommended that patients self-administer, so again, our pharmacists can help. In addition, we can demonstrate the proper technique for self-administering to help patients become more self-sufficient.
We participate in most Med D programs, Commercial Insurance, and Medicaid. We also work with copay programs and other financial support services.
Prescription refills are easy. We follow the progress of the patient’s prescription from beginning to end. After the first delivery, we make sure to get in touch with plenty of time for their next fill. We also follow the authorized refills on the prescription and contact you for updates and authorizations to continue therapy.
For maintenance medications, we offer “Med Sync” service for patients who would like us to manage their medication regimen. We make arrangements to have the prescriptions transferred to us and we coordinate the filling and refilling of all the maintenance medications of the patient.
Evergreen Pharmacy has arrangements with many of our physician clinics and locations giving us access to their EMR, allowing us to gather the information needed for a PA directly from the practices’ electronic medical records. It allows us to communicate with you quickly and efficiently. This can usually be done within a day or so from when we receive the electronic prescription, saving days in the onboarding process and shortening the time between your order and the actual start of therapy. Through electronic communication, we can verify coverage, check clinical information, look at other medications you have prescribed, determine if a PA is required and if needed, start the PA.
Evergreen EMR access can help with maintaining clinical standards and the medication therapy management plan for the patient. It also allows us to be a valuable resource to you and your staff – whether for PA’s or communication on other medication information. If you are interested in allowing Evergreen Pharmacy EMR access, please contact us, and one of our staff can begin the process with your IT department.
View our Patient Referral Forms.
Electronic Medical Records Access
Evergreen Pharmacy has arrangements with many of our physician clinics and locations giving us access to their EMR, allowing us to gather the information needed for a PA directly from the practices’ electronic medical records. It allows us to communicate with you quickly and efficiently. This can usually be done within a day or so from when we receive the electronic prescription, saving days in the onboarding process and shortening the time between your order and the actual start of therapy. Through electronic communication, we can verify coverage, check clinical information, look at other medications you have prescribed, determine if a PA is required and if needed, start the PA.
Evergreen EMR access can help with maintaining clinical standards and the medication therapy management plan for the patient. It also allows us to be a valuable resource to you and your staff – whether for PA’s or communication on other specialty medication information. If you are interested in allowing Evergreen Pharmacy EMR access, please contact us, and one of our staff can begin the process with your IT department.